Job Description
Role Description
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
This position is remote and the working hours are 8am-5pm EST.
Aetna’s Medicaid Care Management Engagement Outreach Hub is a new initiative focused on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members’ needs and create behavioral change. This team has a drive to exceed the delivery of Medicaid Health care services. Focus is on the Hub’s efficiency and productivity efforts whereby the Care Management Associates interact and engage telephonically with members.
- The Engagement Outreach Hub Care Management Associate supports comprehensive coordination of healthcare services through telephonic outreach to and enrollment of our eligible members. Our Engagement Care Management Associates demonstrate a highly energetic blend of salesperson, healthcare navigator and health plan customer support representative.
- Responsible for direct member outreach and engagement.
- Facilitates case assignment and connects identified members to care managers immediately through a warm transfer.
- Successfully enrolls members into care management to support the implementation of care plans.
- Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems.
- Adheres to compliance with policies and procedure/regulatory standards.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
- Qualifications
- 2 years’ experience in healthcare field (i.e. experienced in medical office, hospital setting, medical billing/coding) preferred.
- Experience with computers including knowledge of Microsoft Word, Outlook, and Excel – data entry and documentation within member records preferred.
- Familiarity with basic medical terminology and concepts used in care management preferred.
- Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am to 8:00 pm.
- Strong organizational skills, including effective verbal and written communication skills.
- Bilingual (Spanish) preferred.
- Requirements
- Effective communication, telephonic and organization skills with ability to be agile, managing multiple priorities at one time, and adapting to change with enthusiasm.
- Demonstrates ability to meet daily metrics with speed, accuracy and a positive attitude.
- Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members.
- Completes documentation of each member call in the electronic record, thoroughly completing required actions with a high level of detail to ensure compliance requirements are met with efficiency.
- Works independently and competently, meeting deliverables and deadlines while demonstrating an outgoing, enthusiastic and caring presence telephonically.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants.
- Bilingual (Spanish) preferred.
- Education
- High School diploma or equivalent GED.
- The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent.
- Benefits
- Comprehensive and competitive mix of pay and benefits.
- Medical, dental, and vision coverage.
- Paid time off.
- Retirement savings options.
- Wellness programs and other resources, based on eligibility.
Apply tot his job
Apply To this Job